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Organization

SPINE WEST A PROFESSIONAL LLC

Active
Parent organization
SPINE WEST A PROFESSIONAL LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SPINE WEST A PROFESSIONAL LLC
Authorized official
DAVID RODRIGUEZ (PRACTICE MANAGER)
(303) 494-7773
Entity
Organization

Contact information

Practice address
3555 LUTHERAN PKWY STE 210, WHEAT RIDGE, CO 80033-6037
(303) 494-7773
(303) 494-1104
Mailing address
5387 MANHATTAN CIR STE 200, BOULDER, CO 80303-4283
(303) 494-7773

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Enumeration date
09/01/2020
Last updated
09/01/2020
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